Evaluation of the “Shared Community Follow‐up” after a germ cell tumour—A novel initiative for remote cancer follow‐up enhanced by online patient‐reported outcome measures

Lindner, Oana C; Boon, Ian S; Joffe, Johnathan; Stark, Dan

doi:10.1111/ecc.13264

Cited by 4 publications

(8 citation statements)

References 32 publications

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“…Views about ePRO follow‐up were mixed among patients, and it may not be suitable for all patients. This finding is similar to other studies where patients are offered a choice (Lindner et al, 2020 ; Morrison et al, 2018 ; Qaderi et al, 2021 ). Feelings of abandonment were raised by some, which is common at treatment completion even within face‐to‐face follow‐up (Lydon et al, 2009 ), and is cited in a narrative review of the impact of telehealth interventions (Cox et al, 2017 ).…”

Section: Discussionsupporting

confidence: 91%

“…This finding is similar to other studies where patients are offered a choice (Lindner et al, 2020;Morrison et al, 2018;Qaderi et al, 2021).…”

Section: Effective Questions and Data Monitoringsupporting

confidence: 91%

“…Furthermore, online, electronic PRO (ePRO) could provide additional support (Dickinson et al, 2014 ; National Information Board, 2014 ) that may be absent in a PIFU model. ePRO follow‐up in lung cancer resulted in increased survival and earlier relapse detection (Denis et al, 2017 ), and there are emerging examples of other oncology services providing ePRO follow‐up (Lindner et al, 2020 ; Qaderi et al, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

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‘We do need to keep some human touch’ — Patient and clinician experiences of ovarian cancer follow‐up and the potential for an electronic patient‐reported outcome pathway: A qualitative interview study

Kennedy

Shearsmith

Holmes

et al. 2022

European J Cancer Care

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Objective: This study aimed to explore experiences of follow-up after treatment and views on an electronic patient-reported outcome (ePRO) pathway among ovarian cancer patients and clinicians.Methods: Semi-structured qualitative interviews were conducted with clinicians and patients previously treated for ovarian cancer. Interviews explored experiences of the current follow-up pathway, patients' needs and views on an ePRO pathway enabling patients to report symptoms online rather than attend clinic-based appointments. Transcripts were analysed using framework analysis.Results: Sixteen patients and 10 clinicians participated from four hospitals in England.Four key themes were identified: transition into follow-up, key features of effective follow-up, issues in follow-up and views of ePRO. Both patients and clinicians saw benefits of an ePRO pathway alongside continued access to specialist support and discussed various practicalities (e.g., frequency, introduction and communication).Technology concerns and feelings of abandonment were highlighted as barriers. The proposed impact on clinical and individual patient outcomes was discussed. Conclusion: Patient and clinician views on follow-up and an ePRO pathway informed key recommendations on the development/introduction of ePRO follow-up. Technology use in healthcare will continue to grow and may offer solutions to facilitate responsive and tailored care. Further research should explore the safety, experiences and acceptability of ePRO follow-up.

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Section: Discussionsupporting

confidence: 91%

“…This finding is similar to other studies where patients are offered a choice (Lindner et al, 2020;Morrison et al, 2018;Qaderi et al, 2021).…”

Section: Effective Questions and Data Monitoringsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

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‘We do need to keep some human touch’ — Patient and clinician experiences of ovarian cancer follow‐up and the potential for an electronic patient‐reported outcome pathway: A qualitative interview study

Kennedy

Shearsmith

Holmes

et al. 2022

European J Cancer Care

Self Cite

View full text Add to dashboard Cite

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“…An ePRO follow-up pathway enables patient’s symptoms/needs to be monitored regularly, remotely, and communicated with their clinicians, and prompt face-to-face review when symptoms/concerns are reported. ePRO follow-up services are emerging in the literature [ 22 , 26 – 28 ]. Qualitative interview work conducted in 2018 illustrated that ovarian cancer clinicians and patients were supportive of an ePRO pathway model post-treatment, suggesting the benefits would be reduced hospital visits when well, regaining normality, but continued access to service/clinicians for reassurance when required [ 29 ].…”

Section: Introductionmentioning

confidence: 99%

Electronic patient-reported monitoring of symptoms during follow-up of ovarian cancer patients: a feasibility study

et al. 2022

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Background Ovarian cancer patients require monitoring for relapse. Innovative follow-up methods are increasingly being explored. An electronic patient-reported outcome (ePRO) follow-up pathway was developed for women treated for ovarian cancer. This feasibility study explored patient acceptability and compliance. Methods A single-arm non-blinded prospective feasibility study was undertaken at two hospitals. Participants were women who had completed treatment for ovarian cancer whose clinician was happy for them to be monitored remotely. Automated 3-monthly reminders were sent to participants to complete an ePRO questionnaire and obtain blood tests. Participants were reviewed over the phone by their clinical nurse specialist instead of attending clinic-based follow-up. The primary outcome was compliance (expected ePRO completions/blood tests) across the 12-month study period. Secondary outcomes were recruitment, attrition, resource use, symptom severity/alerts and patient acceptability. Results Twenty-four women consented (50% consent rate), and 13 remained on study at 12 months. Seven women relapsed, 3 chose to withdraw, and 1 withdrew for other clinical reasons. ePRO compliance was high and consistent at 75-82%, although the two hospitals differed. Adherence to the clinical protocol was evident for blood tests and contacts with staff (fewer visits, more phonecalls compared to an earlier audit). End-of-study feedback indicated high patient satisfaction. Conclusions Remote ePRO follow-up for ovarian cancer is feasible and acceptable to patients who are able and willing to participate. However, the low recruitment rate (ineligible + declined) indicate it is not suitable/acceptable to all patients immediately post-treatment. Further large-scale research and implementation work is required, especially in a post-COVID era. Trial registration ClinicalTrials.gov ID: NCT02847715 (first registered 19/05/2016).

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“…Women who had cancer that was more complex (e.g. non-secretors of CA125) [37], had other comorbidities, or low technology/computer con dence, were less likely to feel con dent and reassured on ePRO follow-up. Furthermore, despite attempts, none of the women who withdrew were interviewed, therefore likely missing some negative experiences.…”

Section: Discussionmentioning

confidence: 99%

“It made me feel part of the team, having my homework to do” – Women and specialist nurse experiences of remote follow up after ovarian cancer treatment: a qualitative interview study.

Kennedy

Shearsmith

Holmes

et al. 2022

Preprint

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Purpose. This study aimed to explore ovarian cancer patients’ and specialist nurses’ experiences of participating in a feasibility study of an electronic patient reported outcome (ePRO) follow-up pathway. Women in the feasibility study completed an ePRO questionnaire, had a blood test and telephone consultation with their specialist nurse, instead of face-to-face hospital visits.Methods. All women and the nurses involved were invited to take part in nested semi-structured interviews exploring all aspects of the pathway. Interviews were recorded and transcripts analysed using framework analysis.Results. Twenty interviews were conducted (16 out of 24 feasibility participants, and all 4 nurses involved). Four themes were identified: 1) readiness and motivators (e.g. feeling well), 2) practicalities and logistics (e.g. value of core features), 3) personal impact (e.g. connection and safety) and 4) future role. An underlying theme highlighted how women strived to seek reassurance and gain confidence. Most women and nurses were positive about the ePRO pathway and would happily continue using it. Conclusion. This work provides invaluable insight into the experiences of women on remote ePRO follow-up post-treatment. Important logistic and implementation issues were identified, which will inform future large-scale work to introduce and evaluate remote ePRO methods during cancer follow-up. This work highlights the key factors influencing women’s readiness and acceptability of an ePRO pathway, and how services should be carefully designed to ensure patients feel reassured and confident post-treatment. Further, it highlights that flexibility and patient preference should be considered in remote service delivery.Trial registration: ClinicalTrials.gov ID: NCT02847715 (first registered 19/05/2016)

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Evaluation of the “Shared Community Follow‐up” after a germ cell tumour—A novel initiative for remote cancer follow‐up enhanced by online patient‐reported outcome measures

Cited by 4 publications

References 32 publications

‘We do need to keep some human touch’ — Patient and clinician experiences of ovarian cancer follow‐up and the potential for an electronic patient‐reported outcome pathway: A qualitative interview study

‘We do need to keep some human touch’ — Patient and clinician experiences of ovarian cancer follow‐up and the potential for an electronic patient‐reported outcome pathway: A qualitative interview study

Electronic patient-reported monitoring of symptoms during follow-up of ovarian cancer patients: a feasibility study

“It made me feel part of the team, having my homework to do” – Women and specialist nurse experiences of remote follow up after ovarian cancer treatment: a qualitative interview study.

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